title: The survival outcomes following liver transplantation (SOFT) score: validation with contemporaneous data and stratification of high-risk cohorts.
abstract: Models to project survival after liver transplantation are important to optimize outcomes. We introduced the survival outcomes following liver transplantation (SOFT) score in 2008 (1) and designed to predict survival in liver recipients at three months post-transplant with a C statistic of 0.70. Our objective was to validate the SOFT score, with more contemporaneous data from the OPTN database. We also applied the SOFT score to cohorts of the sickest transplant candidates and the poorest-quality allografts. Analysis included 21 949 patients transplanted from August 1, 2006, to October 1, 2010. Kaplan-Meier survival functions were used for time-to-event analysis. Model discrimination was assessed using the area under the receiver operating characteristic (ROC) curve. We validated the SOFT score in this cohort of 21 949 liver recipients. The C statistic was 0.70 (CI 0.68-0.71), identical to the original analysis. When applied to cohorts of high-risk recipients and poor-quality donor allografts, the SOFT score projected survival with a C statistic between 0.65 and 0.74. In this study, a validated SOFT score was informative among cohorts of the sickest transplant candidates and the poorest-quality allografts.
authors.affiliation: Division of Abdominal Transplantation, Department of Surgery, University of Arizona, Tucson, AZ 85718, USA. arana@surgery.arizona.edu
authors.forename: Abbas
authors.initials: A
authors.lastname: Rana
authors.forename: Tun
authors.initials: T
authors.lastname: Jie
authors.forename: Marian
authors.initials: M
authors.lastname: Porubsky
authors.forename: Shahid
authors.initials: S
authors.lastname: Habib
authors.forename: Horacio
authors.initials: H
authors.lastname: Rilo
authors.forename: Bruce
authors.initials: B
authors.lastname: Kaplan
authors.forename: Angelika
authors.initials: A
authors.lastname: Gruessner
authors.forename: Rainer
authors.initials: R
authors.lastname: Gruessner
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017093:Liver Failure / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D054928:Validation Studies as Topic; D055815:Young Adult
keywords: SOFT score; high-risk; liver transplantation; patient survival